1145-P: Association of Muscle Mass Loss and Diabetes Development in Liver Allograft Recipients

Abstract

There has been increased recognition of the importance of post transplantation diabetes mellitus (PTDM), which is one of the most frequent complications after liver transplantation. Patients with end-stage liver diseases requiring transplantation are prone to be sarcopenic but the association between sarcopenia and PTDM remains inconclusive. We investigated the effect of postoperative muscle mass loss on the risk of PTDM development by measuring muscle area using computed tomography (CT) in Liver Allograft Recipients before and after transplantation. A total of five hundred patients who received liver transplantation between 2005 and 2020 were included from tertiary care hospital. Skeletal muscle area (cm2) at the level of vertebra L3-L5 was measured using CT scans performed before and 1 year after the transplantation, and the area was normalized to height squared (m2). Cox proportional hazard model was used to investigate the associations between the change in the muscle area after the transplantation (Δmuscle area) and the incidence of PTDM. Patients were divided into two groups (with muscle loss and without muscle loss). During the study follow-up period (median 4.9 years), PTDM occurred in 165 patients (33%). Muscle depletion was significantly associated with the increased risk of incident PTDM after adjustment for age, BMI, model for end-stage liver disease score and fasting blood glucose after liver transplantation (hazard ratio, 1.47; 95% confidence interval, 1.23-1.76; p<0.001). Δmuscle area predicted PTDM development with a receiver operating characteristic area under the curve of 0.633 (95% confidence interval, 0.573-0.694). The cumulative incidence of PTDM was significantly higher in the patients with muscle loss than in the patients without muscle loss (P=0.026). The muscle depletion after liver transplantation is associated with the increased risk of PTDM development. Disclosure S. Lee: None. H. Kim: None. Y. Kim: None. M. Lee: None. D. Joo: None. M. Kim: None. E. Kang: None.